California given mixed reviews on preventing disease outbreaks

California’s public health system lacks the capability to test large numbers of the public over a two-month period if an outbreak of disease occurs, researchers have found.

A report released Tuesday shows that the Golden State achieved only half of 10 indicators that researchers chose to ensure that the public is protected against various infectious disease including influenza, tuberculosis, antibiotic-resistant superbugs or salmonella.

While California offered HIV screening through its Medicaid program and had a plan of action should an outbreak occur, among its shortcomings was the inability to meet the federal government’s goal of vaccinating 90 percent of 19- to 35-month-olds against whooping cough. The state also has no requirement to vaccinate teens against HPV, nor does it motivate at least 50 percent of the population to get flu shots, said researchers in “The Outbreaks: Protecting Americans from Infectious Disease.” The report was released by the Trust for America’s Health and the Robert Wood Johnson Foundation.

Officials with the California Department of Public Health did not respond for comment Tuesday.

But California wasn’t alone. It was among 33 other states that ranked similarly, likely because of outdated systems and limited funding, researchers said. The data were collected in fiscal years 2011-2012, and 2012-2013.

“There’s a widespread belief in this country that we have infectious diseases under control, but there’s been some complacency, said Dr. Tom Inglesby, chief executive officer and director of the University of Pittsburgh Medical Center for Health Security, during a teleconference.

“Many infectious disease threats keep me up at night — from the emergence of a new deadly disease, such as the Middle East Respiratory Syndrome (MERS), to the prospect of bioterrorism, to antibiotic resistant infections, to the worsening of mosquito-borne illnesses being driven by changes in the climate.”

Inglesby said it was important to note successes in the nation’s public health system, but the report shows the U.S. remains vulnerable to infectious diseases because of complacency.

“We’ve seen a resurgence of threats, (such as) a spike in measles this year,” he said. “We’ve had thousands of TB cases, mostly in our cities.”

“The bad news is that we found major gaps in the country’s ability to prevent, control and treat outbreaks, leaving Americans at an unacceptable level of unnecessary risk,” he said.

New Hampshire scored the highest in the nation, fulfilling 8 of 10 indicators, while Georgia, Nebraska and New Jersey scored the lowest at 2 each.

That public health is underfunded doesn’t surprise Dr. Jonathan Fielding, health director for the Los Angeles County Department of Public Health.

“There’s no question that funding continues to be an issue, and something we’re constantly fighting, to make sure we can hire enough people,” Fielding said. “At this point, we are at the point where we can respond.”

The public health department is currently embroiled in a political battle with AIDS Healthcare Foundation. The foundation wants to form a smaller Los Angeles city health department, saying the county provides poor service.

But Fielding pointed to 2009 as an example of how the county responded to the H1N1 swine flu threat, vaccinating 250,000 uninsured and underinsured residents.

Fielding also said 4,000 county employees have been trained to respond to an outbreak emergency. The department also is looking ahead to the potential threats of climate change.

“We have a very active group that has been looking at climate change; part of that includes surveillance for communicable diseases, but the problems are much broader, such as heat emergencies,” Fielding said. “Another major issue is water. There are issues of heat, water, pollution, among other things we’re concerned with.”

Researchers with the Trust for America’s Health offered several recommendations to strengthen the nation’s public health system, including increasing the number of Americans receiving recommended vaccinations, improving global networks to prevent emerging new illnesses such as MERS and maintaining defenses against “old-school” threats like malaria and tuberculosis.